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Objective:To discuss the efficacy of rosuvastatin combined with Danhong injection in the treatment of unstable angina pectoris (UAP) and the influence on serum levels of TNF-α, hs-CRP and IL-6.Methods:Totally 72 patients with UAP were random-ly divided into the control group (n=36) and the observation group (n=36).All the patients received the conventional therapy .The control group was given rosuvastatin tablets ,10 mg,po, qd on the basis of the conventional therapy , while the research group was trea-ted with Danhong injection 30ml,ivd, qd on the basic of the control group .All the patients were treated for 2 weeks.The improvements of clinical symptoms and electrocardiogram , and the adverse reactions before and after the treatments were observed .The frequency of onset and duration before and after the treatment were recorded .The levels of blood lipid , TNF-α, hs-CRP and IL-6 before and after the treatment were detected .Results: The total effective rate of the observation group was 91.67％, which was significantly higher than that (72.22％) of the control group (P<0.05).The seizure frequency and duration of the research group were significantly low -er than those of the control group (P<0.05).After the treatment, the lipid indices such as TG, TC and LDL-C, and serum levels of TNF-α, hs-CRP and IL-6 of the two groups decreased significantly , while HDL-C significantly increased , and the differences were sta-tistically significant (P<0.05).The levels of TG, TC, LDL-C, TNF-a, hs-CRP and IL-6 were significantly lower in the observation group than those in the control group , while HDL-C was significantly higher than that in the control group (P<0.05).Conclusion:Danhong injection and rosuvastatin can effectively improve the clinical symptoms of UAP patients , reduce angina frequency and dura-tion, and decrease serum levels of TNF-a, hs-CRP and IL-6 to inhibit inflammation , which is safe and effective , and worthy of clinical application.
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Objective To measure the morphological parameters of the acromion with CT and to analyze their match with the hook plate. Methods From October 2009 to February 2010,spiral CT scanning (with Somatom Emotion16) and three-dimensional reconstruction of bilateral shoulders were conducted in 61 Chinese subjects.They were 24 men and 37 women,aged from 20 to 83 years (average,45.2 years).The thickness,length and width of the acromion were measured and the subacromial shape was observed with software of the CT system to analyze the match between the hook plate and the acromion.Results The mean thickness of the acromion was 0.85 ± 0.13 cm in all subjects,0.94 ± 0.12 cm in males and 0.79 ± 0.10 cm in fe males,with a significant difference between males and females ( t =2.382,P =0.202).The mean acromion length was 2.08 ± 0.20 cm in all subjects,2.09 ± 0.21 cm in males and 2.06 ± 0.18 cm in females,with no significant difference between males and females( t =1.541,P =0.129).The mean acromion width was 3.81 ± 0.52 cm in all subjects,4.34 ± 0.32 cm in males and 3.47 ± 0.25 cm in females,with a significant difference between males and females ( t =2.296, P =0.025 ). Conclusions The acromial morphology varies significantly between genders in Chinese population,particularly in the thickness and width.It is,therefore,necessary to modify the morphological parameters of the hook plate to match better the gender difference in Chinese population.It is optimal that the hook plate should allow individualized pre-moulding to enhance its therapeutic efficacy.
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Objective To investigate the relationship of serum resistin and pancreatic necrosis in the patients with severe acute pancreatitis. Methods Twenty-eight patients with SAP admitted to our hospital from March 2008 to November 2008 were divided into two groups according to the CT scan imaging: necrotic group and non-necrotic group. The enzyme-linked immunosorbent assay (ELISA) was used to test the serum resistin levels. An ROC curve was depicted to predict the pancreas necrosis. Results There were 21 patients in the non-necrotic group and 7 in the necrotic group, and there was no significant difference in terms of sex, age and baseline disease (P>0.05). The resitin levels ranged from 0.1730 ng/ml to 7.4923 ng/ml, with a mean (3.7102±1.6987) ng/ml. The area under the curve of resistin values was 0.884±0.108 (95%CI:0.672～1.097), asymptote signals 0.003, then it was calculated that P=0.003, which was>0.50. Conclusions The serum resistin may be of clinical value to predict the pancreatic necrosis.
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To evaluate the value of Ranson, acute physiology and chronic health evaluation II (APACHE II), Balthazar CT and pancreatitis outcome prediction (POP) scoring systems in predicting the prognosis of severe acute pancreatitis (SAP).
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Background: Resistin level is high in patients with severe acute pancreatitis (SAP), and resistin is expected to be a new marker for evaluating the severity of acute pancreatitis. Objective: To explore the influence of integrated traditional Chinese and Western medicine therapy on serum resistin levels in SAP patients. Design, setting, participants and interventions: Twenty-eight SAP patients meeting inclusion criteria from Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University were included, and the patients were randomly divided into treatment group and placebo group. There were 13 patients in the treatment group and 15 patients in the placebo group. Patients in the treatment group were given traditional Chinese herbal medicine in addition to the conventional treatment. Patients in the placebo group were given placebo in addition to the conventional treatment. Main outcome measures: The serum resistin levels on admission, and days 1, 3, 5, and 7 after the admission were detected. Results: The serum resistin levels on admission in all the patients were higher than normal level, and there was no significant difference between the two groups (P>0.05). On days 1, 3, 5, and 7 after admission, the resistin levels in the treatment group were (3.29+/-1.66) mu g/L, (3.71+/-1.05) mu g/L, (3.08+/-1.47) mu g/L and (3.62+/-1.67) mu g/L, and in the control group (5.16+/-1.93) mu g/L, (5.07+/-1.53) mu g/L, (4.88+/-1.47) mu g/L and (5.12+/-1.48) mu g/L, respectively. The resistin levels were lower in the treatment group than in the control group (P<0.05). Conclusion: Serum resistin level in SAP patients can be decreased by integrated traditional Chinese medicine and Western medicine therapy.
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Background: Although there are some Chinese herbal medicines in treatment of constipation, but no multi-center randomized controlled trials have been carried out to prove their effectiveness. Objective: To evaluate the safety and efficacy of Yunchang Capsule in treatment of functional constipation with deficiency of both qi and yin and internal accumulation of poisonous pathogenic factors syndrome, and to explore the clinical dosage. Design, setting, participants and interventions: A randomized, double-blinded controlled, multicenter trial was conducted. A total of 240 patients with functional constipation from West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, the First Affiliated Hospital of Tianjing University of Traditional Chinese Medicine and Fujian Academy of Traditional Chinese Medicine were randomly divided into three groups: low dose group (80 cases), high dose group (80 cases) and control group (80 cases). Patients in the low dose group were treated with two pills (0.35 g/pill) of Yunchang Capsule and one pill of Yunchang Capsule simulant for three times daily; patients in the high dose group were treated with three pills (0.35 g/pill) of Yunchang Capsule for three times daily; and patients in the control group were treated with three pills (0.35 g/pill) of Biantong Capsule for three times daily. The therapeutic course was 14 days. Main outcome measures: Clinical symptoms, syndromes, and adverse effects were observed before and after the treatment, and blood, urine and stool tests, hepatorenal function and electrocardiogram were also examined. Results: Two cases were excluded, eleven cases were lost to follow-up, and there were 234 patients entered to intention-to-treat (ITT) analysis. After the treatment, the therapeutic effects were calculated by full analysis set (FAS) and per-protocol population set (PPS) analysis respectively. The effects on functional constipation in FAS showed the response rates in the low dose, high dose and control groups were 86.25% (69/80), 82.90% (63/76), and 70.52% (55/78) respectively, and PPS analysis showed the response rates were 85.71% (66/77), 83.56% (61/73), and 70.13% (54/77) respectively. There were no significant differences among the three groups (P>0.05). The effects on traditional Chinese medicine syndrome in FAS showed the response rates in the low dose, high dose and control groups were 78.75% (63/80), 69.74% (53/76), and 67.95% (53/78) respectively, and PPS analysis showed the response rates were 77.92% (60/77), 69.87%(51/73), and 67.53% (52/77) respectively. There were also no significant differences among the three groups (P>0.05). No severe adverse events were observed. Conclusion: Both low dose and high dose of Yunchang Capsule are effective and safe in treatment of functional constipation with deficiency of both qi and yin and internal accumulation of poisonous pathogenic factors syndrome.
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OBJECTIVE: To explore the mechanism of Chaiqin Chengqi Decoction (CQCQD) in treatment of rats with acute necrotizing pancreatitis (ANP). METHODS: Thirty SD rats were randomly divided into 3 groups: sham-operated (SO) group, ANP group and CQCQD-treated group. ANP was induced by retro-pumping 3.5% sodium cholate to common bile duct. Blood sample was collected from abdominal vein for examination and the pancreatic tissue samples were taken for making pathology section 6 hours later. The pancreatic tissue (HE staining) was observed by light microscope. The content of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) was detected with the method of enzyme-linked immunosorbent assay, and the activation of nuclear factor-kappaB (NF-kappaB) in pancreas was detected by immunohistochemical method. RESULTS: Compared with the SO group, there was dramatic increase in the white blood cell (WBC) counts and AMY level in the ANP group (P<0.05, P<0.01). Compared with the ANP group, the WBC counts and AMY level in CQCQD-treated group were significantly reduced (P<0.05). The edema, inflammatory infiltration, haemorrhage and necrosis scores and total pathological score in the ANP group were obviously higher than those in the SO group (P<0.01). The edema, haemorrhage and inflammatory infiltration scores and the total pathological score in CQCQD-treated group were decreased (P<0.05). The integral optical density of NF-kappaB p65 positive cells of pancreas in CQCQD-treated group was lower than that in the ANP group (P<0.05). CONCLUSION: CQCQD can reduce the content of serum TNF-alpha and IL-6, depress the activation of NF-kappaB, and lessen the pancreatic lesions.
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OBJECTIVE: To study the risk factors for severe acute pancreatitis (SAP) complicated by pancreatic encephalopathy (PE). METHODS: Clinical data from 255 patients with SAP from January 2005 to December 2006 were reviewed. Thirty-one SAP patients had PE, and 224 SAP patients did not. Clinical characteristics of SAP patients in both PE group and non-PE group were analyzed. RESULTS: Ranson scale and the incidence rates of acute respiratory distress syndrome (ARDS), renal failure, hypoproteinemia, hypocalcemia and hyperglycosemia in PE group were higher than those in non-PE group (P0.05). Multivariate logistic regression analysis showed that ARDS and hyperglycosemia were high risk factors. Cure rate in PE group was higher than that in non-PE group. CONCLUSION: Nosogenesis of PE is the result of multiple factors. ARDS and hyperglycosemia may be the high risk factors for PE.
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OBJECTIVE: To investigate the therapeutic effect of Yihuo Qingxia method, a traditional Chinese medicine therapeutic method for replenishing qi to activate blood, clearing away heat and dredging intestines, in treating hyperlipoidemia-related severe acute pancreatitis (SAP) in early stage. METHODS: One hundred and four patients with hyperlipoidemia-related SAP were divided into two groups: early group (admitted to hospital within 3 days after onset) and late group (admitted to hospital from 3 days to 7 days after onset). There were 52 cases in each group. All the patients were treated by Yihuo Qingxia method. RESULTS: There were no statistical differences in 48-hour Ranson scores, CT scores, 24-hour acute physiology and chronic heath evaluation II scores (APACHE II scores), and the levels of 24-hour serum triglyceride (TG) and serum glucose in the two groups (P>0.05). At the 10th day after onset, the serum TG level in early group was lower than that in late group (P<0.01). The incidences of acute respiratory distress syndrome, acute renal failure, hepatic inadequacy, congestive heart failure, shock, encephalopathy, infection and alimentary tract hemorrhage in early group were higher than those in late group (P<0.05). The mortality in early group was lower than that in the late group (P<0.05). The length of hospital stay in early group was shorter than that in late group (P<0.05). CONCLUSION: Yihuo Qingxia method has a good efficacy in treating hyperlipoidemia-related SAP in early stage.
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OBJECTIVE: To study the therapeutic effects of Chaiqin Chengqi Decoction (CQCQD) in treating severe acute biliary pancreatitis. METHODS: Ninety patients with severe acute biliary pancreatitis were treated with CQCQD, and they were divided into two groups: early-treated group (54 patients treated with CQCQD within 3 days after the onset of severe acute biliary pancreatitis) and late-treated group (36 patients treated with CQCQD between 3 and 7 days after the onset of severe acute biliary pancreatitis). The complication incidence rate, operation rate, mortality rate and hospitalization period were examined. RESULTS: The incidence rates of encephalopathy, infection and gastrointestinal hemorrhage were lower in the early-treated group than those in the late-treated group (P<0.05). The hospitalization periods of the early- and late-treated groups were (24.9+/-18.4) days and (51.6+/-45.9) days respectively (P<0.05). The general mortality rate was 14.4%. The mortality rate of the early-treated group (7.4%) was significantly lower as compared with that of the late-treated group (25.0%) (P<0.05). The operation rate of the early-treated group (11.1%) was also significantly lower as compared with that of the late-treated group (27.8%) (P<0.05). CONCLUSION: Treating severe acute biliary pancreatitis with CQCQD in early stage may reduce the complication incidence rate, shorten the hospitalization period, and decrease the operation rate and mortality rate.
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OBJECTIVE: To investigate the occurring mechanism and clinical characteristics of severe acute pancreatitis (SAP) associated with hypoalbuminemia in early stage and its influence on prognosis of SAP and the preventive and therapeutic management of this disease. METHODS: One hundred and thirty-eight cases diagnosed as SAP complicated by hypoalbuminemia in early stage were accepted in our hospital from August 1, 2003 to December 31, 2004, and they were divided into 2 groups according to the level of plasma albumin: mild hypoalbuminemia (30 to 35 g/L) group and severe hypoalbuminemia (0.05). The incidence rate of infection and the mortality in the severe hypoalbuminemia group were higher than those in the mild hypoalbuminemia group (P<0.01) in the later stage of SAP. CONCLUSION: Hypoalbuminemia in the early stage can accelerate the deterioration in pathophysiology of SAP. The lower level of the plasma albumin is in the early stage, the more complications and the higher incidence rate of infection and mortality will be in the later stage. To relieve the extent of systemic inflammatory response syndrome (SIRS) and abundant supplement of albumin, amino acid and lipid in time may be crucial to prevent the occurrence and deterioration of hypoalbuminemia.